Robot-Assisted Stereotaxy Reduces Target Error: A Meta-Analysis and Meta-Regression of 6056 Trajectories

Neurosurgery ◽  
2020 ◽  
Author(s):  
Lucas R Philipp ◽  
Caio M Matias ◽  
Sara Thalheimer ◽  
Shyle H Mehta ◽  
Ashwini Sharan ◽  
...  
Keyword(s):  
Intraoperative Imaging ◽  
Meta Analysis ◽  
Multivariable Analysis ◽  
Registration Method ◽  
Electrode Implantation ◽  
Factors Affecting ◽  
Implanted Electrodes ◽  
Target Error ◽  
Meta Regression ◽  
Improved Accuracy

Abstract BACKGROUND The pursuit of improved accuracy for localization and electrode implantation in deep brain stimulation (DBS) and stereoelectroencephalography (sEEG) has fostered an abundance of disparate surgical/stereotactic practices. Specific practices/technologies directly modify implantation accuracy; however, no study has described their respective influence in multivariable context. OBJECTIVE To synthesize the known literature to statistically quantify factors affecting implantation accuracy. METHODS A systematic review and meta-analysis was conducted to determine the inverse-variance weighted pooled mean target error (MTE) of implanted electrodes among patients undergoing DBS or sEEG. MTE was defined as Euclidean distance between planned and final electrode tip. Meta-regression identified moderators of MTE in a multivariable-adjusted model. RESULTS A total of 37 eligible studies were identified from a search return of 2,901 potential articles (2002-2018) – 27 DBS and 10 sEEG. Random-effects pooled MTE = 1.91 mm (95% CI: 1.7-2.1) for DBS and 2.34 mm (95% CI: 2.1-2.6) for sEEG. Meta-regression identified study year, robot use, frame/frameless technique, and intraoperative electrophysiologic testing (iEPT) as significant multivariable-adjusted moderators of MTE (P < .0001, R2 = 0.63). Study year was associated with a 0.92-mm MTE reduction over the 16-yr study period (P = .0035), and robot use with a 0.79-mm decrease (P = .0019). Frameless technique was associated with a mean 0.50-mm (95% CI: 0.17-0.84) increase, and iEPT use with a 0.45-mm (95% CI: 0.10-0.80) increase in MTE. Registration method, imaging type, intraoperative imaging, target, and demographics were not significantly associated with MTE on multivariable analysis. CONCLUSION Robot assistance for stereotactic electrode implantation is independently associated with improved accuracy and reduced target error. This remains true regardless of other procedural factors, including frame-based vs frameless technique.

scholarly journals The relationship of COVID-19 severity with cardiovascular disease and its traditional risk factors: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Kunihiro Matsushita ◽  
Ning Ding ◽  
Minghao Kou ◽  
Xiao Hu ◽  
Mengkun Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Meta Analysis ◽  
Multivariable Analysis ◽  
Renin Angiotensin System ◽  
Regression Analyses ◽  
Male Sex ◽  
Meta Regression ◽  
Traditional Risk Factors

AbstractBackgroundWhether cardiovascular disease (CVD) and its traditional risk factors predict severe coronavirus disease 2019 (COVID-19) is uncertain, in part, because of potential confounding by age and sex.MethodsWe performed a systematic review of studies that explored pre-existing CVD and its traditional risk factors as risk factors of severe COVID-19 (defined as death, acute respiratory distress syndrome, mechanical ventilation, or intensive care unit admission). We searched PubMed and Embase for papers in English with original data (≥10 cases of severe COVID-19). Using random-effects models, we pooled relative risk (RR) estimates and conducted meta-regression analyses.ResultsOf the 661 publications identified in our search, 25 papers met our inclusion criteria, with 76,638 COVID-19 patients including 11,766 severe cases. Older age was consistently associated with severe COVID-19 in all eight eligible studies, with RR >∼5 in >60-65 vs. <50 years. Three studies showed no change in the RR of age after adjusting for covariate(s). In univariate analyses, factors robustly associated with severe COVID-19 were male sex (10 studies; pooled RR=1.73, [95%CI 1.50-2.01]), hypertension (8 studies; 2.87 [2.09-3.93]), diabetes (9 studies; 3.20 [2.26-4.53]), and CVD (10 studies; 4.97 [3.76-6.58]). RR for male sex was likely to be independent of age. For the other three factors, meta-regression analyses suggested confounding by age. Only four studies reported multivariable analysis, but most of them showed adjusted RR ∼2 for hypertension, diabetes, and CVD. No study explored renin-angiotensin system inhibitors as a risk factor for severe COVID-19.ConclusionsDespite the potential for confounding, these results suggest that hypertension, diabetes, and CVD are independently associated with severe COVID-19 and, together with age and male sex, can be used to inform objective decisions on COVID-19 testing, clinical management, and workforce planning.

scholarly journals Systematic Review and Meta-Analysis of Prevalence in Post-Stroke Neurocognitive Disorders in Hospital-Based Studies

2018 ◽  
Vol 46 (5-6) ◽  
pp. 322-334 ◽  
Author(s):  
Mélanie Barbay ◽  
Momar Diouf ◽  
Martine Roussel ◽  
Olivier Godefroy ◽  
Keyword(s):  
Literature Search ◽  
Recurrent Stroke ◽  
Meta Analysis ◽  
Neurocognitive Disorders ◽  
Accurate Estimation ◽  
Factors Affecting ◽  
Post Stroke ◽  
Threshold Score ◽  
Meta Regression ◽  
Meta Regression Analysis

Background/Aims: Post-stroke neurocognitive disorders (post-stroke NCD) have been reported with a very variable prevalence. Methods: Based on a systematic literature search, hospital-based studies published between January 1990 and September 2015 were selected when they reported the prevalence of total, mild, and major post-stroke NCD diagnosed by using specified criteria. Factors affecting prevalence were assessed using meta-regression analysis. Results: Among the 7,440 references evaluated, 16 hospital-based studies were selected, corresponding to a total of 3,087 patients. The overall prevalence of total post-stroke NCD was 53.4% (95% CI: 46.9–59.8): 36.4% for mild post-stroke NCD (95% CI: 29–43.8) and 16.5% (95% CI: 12.1–20.8) for major post-stroke NCD. The overall prevalence was mainly influenced by the threshold score used for categorization (p = 0.0001) and, in the subgroup of studies using a conservative threshold (i.e., ≤7th percentile), by the recurrent stroke rate (p = 0.0005). The prevalence of major post-stroke NCD was mainly influenced by age (p = 0.003). Conclusion: More than half of stroke survivors experience post-stroke NCD, corresponding to mild post-stroke NCD in two-thirds of cases and major post-stroke NCD in one-third of cases. Harmonization of stroke assessment and cognitive score thresholds is urgently needed to allow more accurate estimation of post-stroke NCD prevalence, especially mild post-stroke NCD.

scholarly journals Effect of Dietary Vegetable Sources Rich in Unsaturated Fatty Acids on Milk Production, Composition, and Cheese Fatty Acid Profile in Sheep: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Einar Vargas-Bello-Pérez ◽  
Babak Darabighane ◽  
Florencia E. Miccoli ◽  
Pilar Gómez-Cortés ◽  
Manuel Gonzalez-Ronquillo ◽  
...  
Keyword(s):  
Effect Size ◽  
Milk Fat ◽  
Unsaturated Fatty Acids ◽  
Meta Analysis ◽  
Milk Composition ◽  
Fat Percentage ◽  
Factors Affecting ◽  
Nutritional Strategy ◽  
Meta Regression ◽  
Effect Of Feeding

A meta-analysis was conducted to analyze the effects of different dietary vegetable sources rich in unsaturated FA (UFA) on sheep cheese FA profile. This study also quantified the overall effect of feeding sheep with vegetable sources rich in UFA (linseed, flaxseed, sunflower seed, canola, olive oil, bran oil, and olive cake), on milk yield (MY) and milk composition. A literature search was conducted to identify papers published from 2000 to 2019. Effect size for all parameters was calculated as standardized mean difference. Heterogeneity was determined using I2 statistic, while meta-regression was used to examine factors influencing heterogeneity. Effect size was not significant for MY, milk fat percentage (MFP), and milk protein percentage (MPP). Dietary inclusion of vegetable sources rich in UFA decreased the effect size for C12:0, C14:0, and C16:0 and increased the effect size for C18:0, C18:1 t-11, C18:1 c-9, C18:2 c-9, t-11, C18:2 n-6, and C18:3 n-3. Heterogeneity was significant for MY, MFP, MPP, and overall cheese FA profile. Meta-regression revealed days in milk as a contributing factor to the heterogeneity observed in MFP and MPP. Meta-regression showed that ripening time is one of the factors affecting cheese FA profile heterogeneity while the type of feeding system(preserved roughages vs. pasture) had no effect on heterogeneity. Overall, inclusion of dietary vegetable sources rich in UFA in sheep diets would be an effective nutritional strategy to decrease saturated FA and increase polyunsaturated FA contents in cheeses without detrimental effects on MY, MFF, and MPP.

scholarly journals Effect of electromagnetic field on abortion: A systematic review and meta-analysis

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 1628-1641
Author(s):  
Masumeh Ghazanfarpour ◽  
Zahra Atarodi Kashani ◽  
Reza Pakzad ◽  
Fatemeh Abdi ◽  
Fatemeh Alsadat Rahnemaei ◽  
...  
Keyword(s):  
Pregnant Women ◽  
New Technologies ◽  
Meta Analysis ◽  
World Health ◽  
Cochrane Library ◽  
Factors Affecting ◽  
Increased Risk ◽  
Newcastle Ottawa Scale ◽  
Meta Regression ◽  
Health Organization

Abstract Background The increasing use of new technologies by pregnant women inevitably exposes them to the risks of the electromagnetic fields (EMFs). According to the World Health Organization, EMFs are the major sources of pollutants which harm human health. This study was aimed to evaluate the effects of EMF exposure on abortion. Methods Web of Science, Cochrane Library, MEDLINE, PubMed, EMBASE, Scopus, and Google Scholar were searched until 2021. Pooled odds ratio (OR) with 95% confidence interval (CI) was estimated using a random-effects model. Heterogeneity was explored using Cochran’s Q test and I 2 index. A meta-regression method was employed to investigate the factors affecting heterogeneity between the studies. The Newcastle-Ottawa scale was used to assess the credibility of the studies. Results Eligible studies (N = 17) were analyzed with a total of 57,693 participants. The mean maternal age (95% CI) was 31.06 years (27.32–34.80). Based on meta-analysis results, the pooled estimate for OR of EMF with its effects was 1.27 (95% CI: 1.10–1.46). According to the results of meta-regression, sample size had a significant effect on heterogeneity between studies (p: 0.030), but mother’s age and publication year had no significant effect on heterogeneity (p-value of bothwere >0.05). No publication bias was observed. Conclusion Exposure to EMFs above 50 Hz or 16 mG is associated with 1.27× increased risk of abortion. It may be prudent to advise women against this potentially important environmental hazard. Indeed, pregnant women should receive tailored counselling.

scholarly journals Do not neglect calcium: a systematic review and meta-analysis (meta-regression) of its digestibility and utilisation in growing and finishing pigs

2018 ◽  
Vol 119 (11) ◽  
pp. 1207-1219 ◽  
Author(s):  
Maciej M. Misiura ◽  
João A. N. Filipe ◽  
Carrie L. Walk ◽  
Ilias Kyriazakis
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Accurate Determination ◽  
Growing Pigs ◽  
Finishing Pigs ◽  
Factors Affecting ◽  
Diet Formulation ◽  
Negative Effect ◽  
Meta Regression

AbstractCa digestibility and utilisation in growing pigs are not well understood, and are usually neglected in diet formulation. This has implications not only for the accurate determination of its requirements but also for its interactions with other nutrients. A systematic review and meta-analysis (meta-regression) of published trials was carried out to quantify factors affecting Ca absorption and utilisation, and to derive an estimate of Ca endogenous excretion. The analysis was carried out on the data from forty studies, corresponding to 201 treatments performed on 1204 pigs. The results indicated that although Ca absorption and retention (g/kg of body weight per d) increased with increasing Ca intake (P<0·001), non-phytate-P intake (P<0·001) and exogenous phytase supplementation (P<0·001), these values decreased with increasing phytate-P intake (P<0·05). Interactions between exogenous phytase and Ca intake, indicating reduced efficacy of this enzyme (P<0·001), and between phytate-P intake and exogenous phytase, counteracting the direct negative effect of phytate-P (P<0·05) on Ca absorption and retention, were also detected. There were no effects of animal-related characteristics, such as pig genotype in Ca absorption and retention. The large amount of variance explained in Ca absorption (90 %) and retention (91 %) supported our choice of independent variables. Endogenous Ca losses obtained via linear regression were 239 mg/kg of DM intake (95 % CI 114, 364). These outcomes advance the current understanding of Ca digestibility and utilisation, and should contribute towards establishing requirements for digestible Ca. Consequently, pig diets will be more correctly formulated if digestible Ca values are used in estimating requirements for Ca.

Robot-Assisted Stereotaxy Reduces Target Error: A Meta-Analysis and Meta-Regression of 6056 Trajectories

Neurosurgery ◽  
2021 ◽  
Vol 89 (Supplement_2) ◽  
pp. S79-S79
Author(s):  
Lucas R Philipp ◽  
Caio M Matias ◽  
Sara Thalheimer ◽  
Shyle H Mehta ◽  
Ashwini Sharan ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Robot Assisted ◽  
Target Error ◽  
Meta Regression

scholarly journals Effect of prone position on respiratory parameters, intubation and death rate in COVID-19 patients: systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fatemeh Behesht Aeen ◽  
Reza Pakzad ◽  
Mohammad Goudarzi Rad ◽  
Fatemeh Abdi ◽  
Farzaneh Zaheri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prone Position ◽  
Study Design ◽  
Death Rate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Factors Affecting ◽  
Respiratory Parameters ◽  
Quasi Experimental ◽  
Meta Regression

AbstractProne position (PP) is known to improve oxygenation and reduce mortality in COVID-19 patients. This systematic review and meta-analysis aimed to determine the effects of PP on respiratory parameters and outcomes. PubMed, EMBASE, ProQuest, SCOPUS, Web of Sciences, Cochrane library, and Google Scholar were searched up to 1st January 2021. Twenty-eight studies were included. The Cochran's Q-test and I2 statistic were assessed heterogeneity, the random-effects model was estimated the pooled mean difference (PMD), and a meta-regression method has utilized the factors affecting heterogeneity between studies. PMD with 95% confidence interval (CI) of PaO2/FIO2 Ratio in before–after design, quasi-experimental design and in overall was 55.74, 56.38, and 56.20 mmHg. These values for Spo2 (Sao2) were 3.38, 17.03, and 7.58. PP in COVID-19 patients lead to significantly decrease of the Paco2 (PMD: − 8.69; 95% CI − 14.69 to − 2.69 mmHg) but significantly increase the PaO2 (PMD: 37.74; 95% CI 7.16–68.33 mmHg). PP has no significant effect on the respiratory rate. Based on meta-regression, the study design has a significant effect on the heterogeneity of Spo2 (Sao2) (Coefficient: 12.80; p < 0.001). No significant associations were observed for other respiratory parameters with sample size and study design. The pooled estimate for death rate and intubation rates were 19.03 (8.19–32.61) and 30.68 (21.39–40.75). The prone positioning was associated with improved oxygenation parameters and reduced mortality and intubation rate in COVID-19 related respiratory failure.

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